While orphans and amputees are the most visible victims of war, Cambodian society today is filled with millions of people suffering mental disorders linked to the country’s violent past, a mental health group reported Thursday.
“Though the war has stopped, the consequences of war are still acting on the Cambodian people today,” said Mustafa Elmasri, a psychiatrist with the Transcultural Psychosocial Organization. “What the war has done is create a social upheaval that has extended inside the family and started to fragment the family itself.”
Based on a survey of more than 600 Cambodians in three provinces, researchers from TPO say nearly one in three Cambodians suffer serious mental problems from witnessing or undergoing traumatic events, and one in nine suffers serious depression. The more traumatic events Cambodians were exposed to, the higher the incidence of mental disorders and family problems such as marital stress and alcohol abuse.
“While the war events are decreasing, family and communal conflicts and stresses are increasing,” Elmasri said. “With the passage of time, each year they had more problems in that area.”
The survey was conducted in 1996 and 1997 by staff of the TPO, a Dutch organization that has been working with the Cambodian government since 1995 to diagnose Cambodians with psychological and social disorders and treat them.
Researchers asked respondents in Battambang, Phnom Penh and Kompong Speu 50 questions, ranging from how many violent events they had witnessed to how often they feel grief or have trouble sleeping.
Thirteen percent of respondents showed signs of serious depression while 28 percent showed signs of post-traumatic stress disorder, a mental illness arising from severe trauma.
“This rate is high compared to developed countries, but it is similar to the prevalence in countries that have been exposed to a history of war and violence,” Elmasri said.
The most intense and widespread exposure to violent events came during the Khmer Rouge regime. “Nonetheless,” the report says, “sporadic events of exposure to torture, injuries from land mines, imprisonment and witnessing violence in the community still exist.”
The highest incidence of post-traumatic stress and major depression was with widows and divorced or separated women, who made up about 20 percent of survey respondents. Sixty percent of them suffer from post-traumatic stress and 36 percent suffer from depression.
Among those suffering mental disorders from trauma, less than one in four had sought medical help.
“People try to live their life and endure their symptoms if they can function day to day, and only seek help if their symptoms interfere a lot with their daily living,” the report states.
Mental health experts from TPO said it takes most Cambodians a long time before they seek the help of a counselor or psychiatrist. In the meantime, people visit pharmacists, traditional healers and doctors not trained in mental health looking for relief—and, many times, selling off their possessions to pay for treatment.
TPO counselors, funded by the Dutch, do not charge for treatment.